Psychopharmacology Tips

Migraine occurs approximately six times as often with bipolar disorder as would be expected by chance (Breslau et al., 1994). Several well-designed, placebo-controlled, randomized trials have shown significant superiority of divalproex sodium compared with placebo in reducing the frequency of migraine episodes (Mathew et al., 1995; Jensen et al., 1994 and Silberstein et al., 1993). Hence, divalproex may be the mood stabilizer of choice in bipolar disorder patients who have comorbid migraine. Migraine prophylaxis with divalproex sodium appears to be most effective for patients with frequent attacks of migraine with classical symptoms, such as aura (Rothok et al., 1994).

Ref:-

Breslau, N., Merikangas, K. & Bowden, C.L. (1994) Comorbidity of migraine and major affective disorders. Neurology, 44 Suppl. 7, S17–S22.

Jensen, R., Brinck, T. & Olesen, J. (1994) Sodium valproate has a prophylactic effect in migraine without aura. A triple-blind, placebo-controlled crossover study. Neurology, 44, 647–651.

Mathew, N.T., Saper, J.R., Silberstein, S.D., Rankin, L., Markley, H.G., Solomon, S., Rapoport, A.M., Silber, C.J. & Deaton, R.L. (1995) Migraine prophylaxis with divalproex. Archives of Neurology, 52, 281–286.

Rothok, J.F., Kelly, N.M., Brody, M.L. & Golbeck, A. (1994) A differential response to treatment with divalproex sodium in patients with intractable headache. Cephalalgia, 14, 241–244.

Silberstein, S.D., Saper, J.R. & Mathew, N.T. (1993) The safety and efficacy of divalproex sodium in the prophylaxis of migraine headache: a multicenter double-blind, placebo-controlled trial. Headache, 33, 264–265.